Prognosis of epilepsy

It has been a widely accepted view that epilepsy is usually a chronic condition in which the prognosis is generally poor and any remissions that do occur are usually temporary. In this article recent studies challenging this view will be considered, other aspects of the long-term prognosis for seizure control in epilepsy reviewed, and the mortality rates and causes of premature death in epilepsy outlined.     

Pediatric parenteral nutrition management using a comprehensive user-friendly computer program designed for personal computers

The use of parenteral nutrition is becoming more widespread. The need for individualized parenteral nutrition solutions in pediatric patients makes the ordering and preparation of these solutions more complex and error-prone. A computer program is described which performs comprehensive management of parenteral nutrition by assisting in accurately ordering and preparing parenteral nutrition solutions. It also performs extensive error-checking and provides additional nutritional information. Data base management is also a feature which permits future large scale analysis of parenteral nutrition data for research purposes. This program, designed to run on a personal computer, is very comprehensive, yet flexible and user-friendly.     

Actions of phencyclidine on the action potential and membrane currents of single guinea-pig myocytes

The direct actions of phencyclidine (PCP) on mammalian sarcolemma were examined by determination of the drug's effects on the action potentials of isolated guinea-pig ventricular cells, and on the underlying ionic currents. PCP (10(-6) to 10(-4) M) did not alter the resting membrane potential but produced a dose-dependent prolongation of the duration of the action potential, and a reduction of the rate of depolarization of phase 0 (Vmax) of the action potential. Voltage clamp experiments revealed that PCP blocks both myocardial Ca++ channels and myocardial time-dependent K+ channels. The K+ channel blockade was shown to exhibit an apparent voltage-dependence. The effects of PCP on these ionic channels could explain previous reports of it prolonging myocardial action potentials and conflicting reports of positive and negative inotropism.     

Clinical evaluation of norfloxacin in gonococcal urethritis

Norfloxacin, a new quinolinecarboxylic acid derivative, was administered to 30 male patients with gonococcal urethritis at a daily dose of 600 mg for 7-21 days. The clinical response was evaluated after administration of 7 days as excellent; Negative culture of N. gonorrhoeae. WBC less than 3/hpf in first voided urine sediment, good; Negative culture, WBC greater than or equal to 3/hpf, and poor; Positive culture. The result was excellent in 14 cases and good in 16 cases. No subjective side effects were observed. The minimum inhibitory concentration (MIC) distribution against the clinically isolated 30 strains of N. gonorrhoeae ranged from 0.0096 micrograms/ml to 0.34 micrograms/ml. Seven of thirty strains were resistant to ABPC. The MIC of these 7 strains ranged from 0.018 micrograms/ml to 0.18 micrograms/ml. Seven cases with ABPC resistant strains had a similar clinical response to other cases. Twelve patients (40%) developed post gonococcal urethritis for 7-14 days after treatment. Clinical observation of this series suggests that a 7 day therapy of Norfloxacin for the patients with gonococcal urethritis is sufficiently effective and that treatment should be changed to other antibacterial agents in the case of post gonococcal urethritis, since continuous administration for more than 7 days of Norfloxacin is not so effective.     

Laterality of cross-modal spatial processing

This study examined the laterality of spatial-form perception in normal adults using a cross-modal matching paradigm involving visual and tactile processing. Randomly generated eight-point and 12-point Vanderplas and Garvin (1959) patterns were used as the stimuli. In a visual-to-tactile task, a lateralized visual pattern was followed immediately by a haptic task requiring subjects to discriminate which of two simultaneously felt shapes matched the visual pattern. In a tactile-to-visual task, subjects decided which of two simultaneously felt shapes matched a lateralized visual pattern presented after haptic manipulation. There were no main effects for laterality or for sex differences. Matching accuracy was better in the visual-to-tactile task and for less complex stimuli. A visual field by feeling hand interaction showed best recognition accuracy when visual-feeling hand combinations on the same side of the body were used in the two matching tasks. These data reflect a stimulus-response compatibility explanation of spatial-form perception that is consistent with a behavioral and not a cerebral asymmetry model.     

Peripheral neuropathies during treatment with cisplatin: clinical and electrophysiologic study of 11 cases

Eleven patients with bronchial epidermoid carcinoma and undergoing treatment with cis-D.D.P. (II) were kept under electrophysiological and clinical surveillance. No other neurotoxic medication was added. The total dose of cis-D.D.P. was 300 mg/m2 over a period of three months: namely, three courses of 100 mg/m2 distributed over 5 days. Following the pretreatment check-up, the patients were divided into two groups: those without any electrophysiological abnormality (group A), and those without clinical abnormality but with a delayed latency H of the Hoffmann Reflex (group B). Patients in group A showed a slowing down of the motor nerve conduction velocity of the Median and Peroneal Nerves after a course of 100 mg, without accompanying worsening of the conduction velocity after 300 mg/m2, and prolongation of the distal latency of the sensory Median Nerve after 300 mg/m2; in group B, no significant change of electrophysiological clinical features were noted. In the two groups a non-significant reduction in amplitude of evoked responses were noted. These findings are more consistent with an axonal injury than with functional myelin injury. The authors review the existing literature and discuss the physiopathologic mechanisms of cis-D.D.P. peripheral neuropathies.